Provider Demographics
NPI:1083649537
Name:CHANDER MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:CHANDER MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WEN-YUAN
Authorized Official - Middle Name:MARIEANNE
Authorized Official - Last Name:CHIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:310-493-8505
Mailing Address - Street 1:PO BOX 3547
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-3547
Mailing Address - Country:US
Mailing Address - Phone:310-631-3502
Mailing Address - Fax:310-631-5143
Practice Address - Street 1:9844 ATLANTIC AVE
Practice Address - Street 2:SUITE #A
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-5219
Practice Address - Country:US
Practice Address - Phone:310-631-3502
Practice Address - Fax:310-631-5143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8521207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty